Breast Cancer: Why are so few women having reconstructive surgery?

In Breast Cancer Awareness Month, a new report reveals the scandalously low number of women being offered reconstructive surgery following a mastectomy. A report from the NHS Information Centre and Royal College of Surgeons says that just 48 per cent of women with breast cancer were offered the option of reconstruction in 2007-08. The findings, part of an ongoing National Mastectomy and Breast Reconstruction Audit, also showed up wide variations in those undergoing surgery in different parts of England and Wales.

Breast cancer is the most common form of cancer in the UK – about 45,000 women a year are diagnosed with it, of which almost 12,000 die. Chances of survival have improved due to an increasingly effective screening programme and a new generation of drugs. The number of women having a breast cancer operation, either a lumpectomy, in which the tumour is removed, along with up to 25 per cent of the breast tissue, or a mastectomy, in which the whole breast is removed has also increased, by 37 per cent, from 24,684 in 1997 to 33,814 in 2008.

But only 21 per cent of breast cancer patients had an immediate reconstruction in 2008-09 and, although this is up from 11 per cent in 2005-06, it still falls far short of the 100 per cent of eligible women that Nice (the National Instutute of Clinical Excellence, which decide which drugs and procedures the NHS can spend its budget on) in 2002 recommended should receive reconstruction.

Dr Chris Caddy, consultant plastic surgeon at the Sheffield Teaching Hospital NHS Foundation Trust, the lead plastic surgeon on the NHS audit recognises that improvements are needed. “There is a shortfall in access to breast reconstruction,” he admits. “We’re carrying out the audit to find out what the level of service is and where the shortfalls are.”

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